August 2015

OA treatment outperforms usual care with regard to pain but not sensitization

In the moment: Knee OA

The mechanism by which an integrated nonsurgical treatment program reduces pain in patients with knee osteoarthritis (OA) does not appear to involve pain sensitization, according to research from Denmark.

Investigators from Aalborg University in Aalborg randomized 100 patients with knee OA to receive usual care (two educational leaflets and treatment advice) or a three-month treatment program including neuromuscular exercise, education, diet, insoles, and pain medication.

At three months, patients in the intervention group had greater improvements from baseline than those in the usual care group for peak pain intensity, pain after 30 minutes of walking, and number of body sites with pain. However, sensitization improved in both groups compared with baseline, and the change in sensitization did not differ significantly between the groups.

The findings, which were epublished on August 1 by Osteoarthritis & Cartilage, suggest that mechanisms other than pain sensitization contributed to the patients’ perceived pain. However, the authors hypothesized that pain sensitization might play a larger role in patients with more severe disease or in other subgroups of patients.